天冷急性青光眼暴增　中年婦眼痛到揪心

天冷急性青光眼暴增　中年婦眼痛到揪心

.作者： 健康醫療網／林宜慧報導 | 健康醫療網 – 2012年12月11日 下午4:51.. .



（健康醫療網／林宜慧報導）氣溫驟降，眼科門診急性青光眼的病患從1個月2-3例暴增至3天內出現6例，日前一名60歲婦人，就醫時眼壓高達58毫米，視力僅能看到眼前光線，婦人眼睛劇痛到連心臟都揪在一起，醫師判斷因為白內障過熟造成眼壓上升，加上氣候驟降，誘發急性青光眼發作，經緊急手術後，目前眼壓已控制在正常範圍內，術後視力0.6。

60歲的葉姓婦人自述，眼壓高的問題從多年前就開始，原本只有晚上痛，至診所求診，醫師告訴她熱敷即可緩解，但眼睛痛的情形越來越頻繁，甚至眼睛紅腫、淚水直流，而後住院試過打針、吃降眼壓藥，持續1個月都未能穩定控制眼壓，直到轉至大醫院緊急進行白內障摘除及青光眼合併手術，眼壓才控制在正常範圍（正常值：20以下）內，雖然受損的視神經已無法挽救，但幸好術後視力仍保有0.6。

三軍總醫院眼科部主任呂大文指出，急性青光眼好發於隅角閉鎖型的青光眼患者，而台灣有35%的急性青光眼病患屬於此類型，尤其是身高低於160公分，有100-400度遠視，年齡大於55歲以上的女性，加上原本就有白內障，即成為急性青光眼的高危險群。

尤其冬季氣溫驟降，眼部血管收縮、瞳孔放大，造成眼壓升高，是急性青光眼的好發時期，症狀除了眼球脹痛、視力突然模糊不清，也會伴隨著頭痛、嘔吐、血壓上升等現象，因此部分患者可能被誤診為高血壓或是中風，耽誤了就診時間，使視神經受損，若眼壓維持60-70超過3天，可能造成失明。

呂大文主任提及，歐美國家和香港地區，針對高危險族群預防急性青光眼發作的方式，是提早摘除白內障；而目前台灣的眼科醫師多半建議病人在視力降到0.4左右，或是會影響生活時再進行白內障手術。呂主任也提醒高危險群，平時用手電筒照射眼睛，觀察左右瞳孔是否一樣大，並且在冬季注意全身保暖，都是預防急性青光眼的日常方法。

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